The model of the Best Practice Unit (BPU) is a specific form of practice based research. It is a variation of the Community of Practice (CoP) as developed by Wenger, McDermott and Snyder (2002) with the specific aim to innovate a professional practice by combining learning, development and research. We have applied the model over the past 10 years in the domain of care and social welfare in the Netherlands. Characteristics of the model are: the interaction between individual and collective learning processes, the development of (new or better) working methods, and the implementation of these methods in daily practice. Multiple knowledge sources are being used: experiential knowledge, professional knowledge and scientific knowledge. Research is serving diverse purposes: articulating tacit knowledge, documenting the learning and innovation process, systematically describing the revealed or developed ways of working, and evaluating the efficacy of new methods. An analysis of 10 different research projects shows that the BPU is an effective model.
DOCUMENT
Since the start of the COVID-19 pandemic, online supervision has increased markedly, including within the Dutch probation services. In the present research, we systematically collected and analysed both clients and probation officers’ experiences of working online in the prior year. Although the clients were generally positive about remote supervision, some expressed that they missed the personal contact. According to most of the probation officers, remote working is flexible (efficient, saves time, travel costs), appropriate for certain phases of the probation process (especially at a later stage when a working alliance has been established) and particularly suitable for probationers with mild problems and low risk profiles. The general experience was that conversations are both more pragmatic and business-like, which, in turn, can produce both strengths and limitations. Once a foundation has been established, it appears to be possible to continue working remotely with clients, albeit the probation officers stressed that this depended on the type of client, type of offence and risk level.
DOCUMENT
Abstract Background: Nurses are consistently present throughout the rehabilitation of older patients but are apprehensive about performing goal-centred care in the multidisciplinary team. Objectives: The aim of this review was to explore working interventions on setting goals and working with goals designed for nurses in geriatric rehabilitation, and to describe their distinctive features. Methods: We performed a scoping review. We searched MEDLINE and CINAHL through August 4, 2021. Search terms related to the following themes: nurses, rehabilitation, geriatric, goal and method. We used snowballing to find additional. From the selected studies, we systematically extracted data on means, materials and the nursing role and summarized them in a narrative synthesis, using intervention component analysis. Results: The study includes 13 articles, describing 11 interventions which were developed for six different aims: improving multidisciplinary team care; increasing patient centredness; improving disease management by patients; improving the psychological, and emotional rehabilitation; increasing the nursing involvement in rehabilitation; or helping patients to achieve goals. The interventions appeal to four aspects of the nursing profession: assessing self-care skills incorporating patient's preferences; setting goals with patients, taking into account personal needs and what is medically advisable; linking the needs of the patient with multidisciplinary professional treatment and vice versa; and thus, playing an intermediate role and supporting goal achievement. Conclusions: The interventions show that in goal-centred care, the nurse might play an important unifying role between patients and the multidisciplinary team. With the support of nurses, the patient may become more aware of the rehabilitation process and transfer of ownership of treatment goals from the multidisciplinary team to the patient might be achieved. Not many interventions were found meant to support thenursing role. This may indicate a blind spot in the rehabilitation community to the additional value of its contribution.
DOCUMENT
Probation and after-care service is of great social importance and you want to do a proper job. ‘Doing a proper job’ tends to revolve around effective interventions or instruments. Which is important, but doing a proper and effective job involves more than that. We distinguish three forms of effectiveness: -Effective methods: what works? For example, working according to the principles of Risk, Needs and Responsivity6. Or structured behavioural training according to the cognitive-behavioural model. Or working according to the Good Lives Model7. Or the network approach. Methods are referred to as ‘effective’ if there is scientific evidence that they increase the chances of achieving the probation objectives. The risk of recidivism decreases if you work according to these methods. Proper coordination of the working method with specific clients is always part of an effective methodology. -Effective professionals: who works? Methodologies do not lead a life of their own, they only become effective in the hands of professionals8. Effective professionals are rooted in professional values, work with theoretically consistent methods, stand behind their working methods, are able to interact with different types of people (also with people who find this difficult) and systematically provide specific feedback on their actions and results. The importance of effective and open client feedback is important in this. Furthermore, an effective professional attempts to connect his own experiential knowledge to scientific knowledge to the best of his ability. A professional who meets these characteristics is in a better position than other professionals to ‘ensure the effectiveness’ of the method. -Effective interactions: the working alliance (how does it work?) Methodologies and professionals gain meaning in proper interaction with clients and other stakeholders (for example, social network and volunteers). A proper quality of the working alliance increases the chance of successful completion of a probation programme. The risk of problems within the process is reduced and the risk of dropout (no-show or a negative report) decreases.
DOCUMENT
BackgroundWorking alliance can possibly influence patients’ experiences of pain and physical functioning. The aim of this systematic review is to merge evidence from literature regarding the influence of patients’ perceived working alliance on pain and physical functioning in patients with chronic musculoskeletal pain.MethodsA systematic review in which randomized controlled trials and cohort studies were included that assessed the influence of working alliance on either pain or physical functioning in patients with chronic musculoskeletal pain. The methodological quality of the included studies were rated by means of the PEDro score and STROBE statement.ResultsThe first step of the search process provided 1469 studies. After screening, five studies were included in this review including one RCT and four cohort studies of patients with chronic musculoskeletal pain. One cohort study was rated as low methodological quality and the other studies as high methodological quality. There was a significant effect of working alliance on the outcome of pain severity, pain interference, and physical functioning in all studies. Physical functioning was measured by means of questionnaires and functional capacity tests. The effect on questionnaires was positive; the effect was conflicting on functional capacity.ConclusionWhen influencing pain with treatment, a patient’s perceived working alliance during treatment does predict pain reduction and improvement in physical functioning. It is recommended to inquire about a patient’s working alliance during treatment in patients with chronic musculoskeletal pain.
DOCUMENT
Due to the changing technological possibilities of services, the demands that society places on the level of service provided by the Dutch Central Government (DCG) are changing rapidly. To accommodate this, the Dutch government is improving its processes in such a way that they become more agile and are continuously improved. However, the DCG struggles with the implementation of improvement tools that can support this. The research described in this paper aims to deliver key factors that influence the adoption of tools that improve the agile way of working and continuous improvement at the DCG. Therefore, a literature review has been conducted, from which 24 factors have been derived. Subsequently, 9 semi structured interviews have been conducted to emphasize the perspective of employees at the DCG. In total, 7 key factors have been derived from the interviews. The interviewees consisted of both employees from departments who already worked with tools to improve agile working and continuous improvement as well as employees from departments who haven’t used such tools yet. An important insight based on this research is that the aims, way of working and scope of the improvement tools must be clear for all the involved co-workers
MULTIFILE
The COVID-19 pandemic has accelerated remote working and working at the office. This hybrid working is an indispensable part of today's life even within Agile Software Development (ASD) teams. Before COVID-19 ASD teams were working closely together in an Agile way at the office. The Agile Manifesto describes 12 principles to make agile working successful. These principles are about working closely together, face-to-face contact and continuously responding to changes. To what extent does hybrid working influence these agile principles that have been indispensable in today's software development since its creation in 2001? Based on a quantitative study within 22 Dutch financial institutions and 106 respondents, the relationship between hybrid working and ASD is investigated. The results of this research show that human factors, such as team spirit, feeling responsible and the ability to learn from each other, are the most decisive for the success of ASD. In addition, the research shows that hybrid working creates a distance between the business organization and the IT department. The findings are valuable for Managers, HR professionals and employees working in the field of ASD as emphasizing and fostering Team Spirit, Learning Ability, and a Sense of Responsibility among team members can bolster the Speed of ASD.
MULTIFILE
The concept of a working alliance is rooted in psychotherapy and has been studied extensively in that field. Much less research has been conducted into working alliances between chronic psychiatric patients and their case managers. The aim of this review was to identify what is known about the working alliance between chronic psychiatric patients and their case managers. An extensive survey of the literature produced 14 articles for this review. The results of studies conducted show that a good working alliance has positive effects on the functioning of patients, and that the quality of the alliance depends on both patient characteristics and the behaviour of the case managers. The results also indicate that the working alliance is largely determined in the first 3 months of the contact. Further research into the development of working alliances is necessary.
MULTIFILE
Objective: A key aspect of psychiatric rehabilitation is supporting individuals with serious mental illness in reaching personal goals. This study aimed to investigate whether various aspects of the working alliance predict successful goal attainment and whether goal attainment improves subjective quality of life, independent of the ehabilitation approach used. Methods: Secondary analyses were conducted of data from a Dutch randomized clinical trial on goal attainment by individuals supported with the Boston University approach to psychiatric rehabilitation (N=80) or a generic approach (N=76). Working alliance was measured with the Working Alliance Inventory (WAI) from the practitioner’s perspective. Rehabilitation practitioners had backgrounds in social work, nursing, or vocational rehabilitation. Multiple logistic regression and multiple regression analyses explored effects of working alliance on goal attainment and of goal attainment on subjective quality of life at 24 months. Analyses were controlled for client- and process-related predictors, baseline quality of life, and rehabilitation approach. Results: The WAI goal subscale predicted goal attainment at 24 months. No effect was found for the bond or task subscale. Goal attainment significantly predicted quality of life at 24 months. These effects were independent of the rehabilitation approach used. Conclusions: A good bond between client and practitioner is not enough to attain successful rehabilitation outcomes. Findings suggest that it is important to discuss clients’ wishes and ambitions and form an agreement on goals. Attaining rehabilitation goals directly influenced the subjective quality of life of individuals with serious mental illness, which underscores the importance of investing in these forms of client support.
MULTIFILE
To adequately deal with the challenges faced within residential care for older people, such as the increasing complexity of care and a call for more person-centred practices, it is important that health care providers learn from their work. This study investigates both the nature of learning, among staff and students working within care for older people, and how workplace learning can be promoted and researched. During a longitudinal study within a nursing home, participatory and democratic research methods were used to collaborate with stakeholders to improve the quality of care and to promote learning in the workplace. The rich descriptions of these processes show that workplace learning is a complex phenomenon. It arises continuously in reciprocal relationship with all those present through which both individuals and environment change and co-evolve enabling enlargement of the space for possible action. This complexity perspective on learning refines and expands conventional beliefs about workplace learning and has implications for advancing and researching learning. It explains that research on workplace learning is itself a form of learning that is aimed at promoting and accelerating learning. Such research requires dialogic and creative methods. This study illustrates that workplace learning has the potential to develop new shared values and ways of working, but that such processes and outcomes are difficult to control. It offers inspiration for educators, supervisors, managers and researchers as to promoting conditions that embrace complexity and provides insight into the role and position of self in such processes.
DOCUMENT
